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Online Forms

Are you covered by a comparable plan? Do you wish to cover your dependents? Or Have you opted out of the plan and wish to be re-enrolled? Eligible Students may submit their online forms.

Submitting Online Applications

Before submitting your online forms, please review the eligibility criteria and read the Terms and Conditions.

Opt-Out Application

If you are covered by a comparable Health and Dental Plan from parents, spouse, work, government, or band and do not wish to Coordinate Benefits, you may submit an online Opt-Out application.

Family Add-On Application

Extend your plan to your dependents and provide the same protection you have. Additional charges that must be paid using a credit card.

Re-enroll Application

If you previously opted out of the plan and have lost your comparable coverage or a lifestyle change occurred, you may re-enroll into the Student Plan.
Deadline

Deadline to submit applications